While many economic studies have explored the role of prenatal care in infant health production, the literature is sporadic on the effects of prenatal care on the mother. This research contributes to this understudied but important area using a unique large dataset of sibling newborns delivered by 0.17 million mothers. We apply within-mother estimators to find robust evidence that poor prenatal care utilization due to late onset of care, low frequency of care visits, or combinations of the two significantly increases the risks of maternal insufficient gestational weight gain, prenatal smoking, premature rupture of membranes, precipitous labor, no breastfeeding, postnatal underweight, and postpartum smoking. The magnitude of the estimates relative to the respective sample means of the outcome variables ranges from 3% to 33%. The results highlight the importance of receiving timely and sufficient prenatal care in improving maternal health and health behaviors during pregnancy as well as after childbirth. Copyright © 2016 John Wiley & Sons, Ltd.
Smoking during pregnancy is a key contributor to poor infant health. Our study presents a dynamic relationship between the timing of prenatal smoking cessation or reduction and infant birth weight. Using a large representative dataset of a birth cohort in the United Kingdom, we apply regression analysis to examine the influences of cessation in smoking or reduction in smoking intensity at different months or trimesters on infant birth weight. For robustness checks, we use a rich set of additional covariates, a series of variable selection procedures, alternative birth outcome measures, and stratified samples. We find robust evidence that mothers who quit smoking by the third month of pregnancy or the end of the first trimester have infants of the same weight as those infants of nonsmokers. However, we find smoking cessation in the fourth month or any time beyond is associated with substantially lower infant birth weights. Two-thirds of the total adverse smoking impact on infant birth weight occurs in the second trimester. Our study also shows mothers who smoke throughout pregnancy but cut smoking intensity by the third month in pregnancy deliver infants of the same weight as those infants born to persistent light smokers. Our research suggests the efficacy of prenatal smoking cessation services can be significantly improved, if health professionals can encourage more pregnant women to quit smoking or reduce smoking intensity timely by the end of the first trimester.
In the United States, the high prevalence of unhealthy preconception body weight and inappropriate gestational weight gain among pregnant women is an important public health concern. However, the relationship among pre-pregnancy BMI, gestational weight gain, and newborn birth weight has not been well established. This study uses a very large dataset of sibling births and a within-family design to thoroughly address this issue. The baseline analysis controlling for mother fixed effects indicates maternal preconception overweight, preconception obesity, and excessive gestational weight gain significantly increase the risk of having a high birth weight baby, respectively, by 1.3, 3 and 3.9 percentage points, while underweight before pregnancy and inadequate gestational weight gain increase the low birth weight incidence by 1.4 and 2 percentage points. The benchmark results are robust in a variety of sensitivity checks. Since poor birth outcomes especially high birth weight and low birth weight have lasting adverse impacts on one's health, education, and socio-economic outcomes later in life, the findings of this research suggest promoting healthy weight among women before pregnancy and preventing inappropriate weight gain during pregnancy can generate significant intergenerational benefits Yan, Ji (2015) "Maternal pre-pregnancy BMI, gestational weight gain, and infant birth weight: A withinfamily analysis in the United States"
This paper studies whether adolescents who are more aware of the risks on substance use in the early teenage years are later less likely to turn into binge drinkers or smokers. It also examines if reduction in substance use, due to high risk perception among adolescents, consequently improves their educational achievement. This research is important for two reasons. First, enhancing risk perception of substance use is an important strategy to prevent the youth from binge drinking and smoking. Second, adolescent substance use and educational achievement are key predictors of adulthood outcomes. We apply a bivariate probit model to a large representative dataset which codes youth risk perception, substance use, and educational attainment. The analysis shows high risk perception lowers the likelihood of substance use among the high school seniors. The resulting low alcohol use increases the chance of attending college and decreases the probability of dropping out of high school. The reduction in cigarette use caused by high risk perception has a similar effect on such two educational outcomes. It also increases high school graduation by 22 percent. Overall, this study suggests that enhancing recognition on the hazards of substance use is an effective policy intervention to reduce adolescent binge drinking and smoking, as well as improve educational attainment.
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